Membership/Gift Form
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EAGLE HISTORICAL
SOCIETY & MUSEUMS Membership/Gift Form |
You may mail this application with your check to: Membership
Chair, Eagle Historical Society and Museums, PO Box 23, Eagle, AK
99738-0023.
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Check |
__Individual Annual $10.00 | |||||||||
| __Family Annual $15.00 | ||||||||||
| __Business/Inst. Annual $25.00 | ||||||||||
| __*Sponsoring Annual* $50.00 | * New members at these levels receive a complimentary | |||||||||
| __*Supporting Annual* $100.00 | copy of "Jewel On The Yukon: Eagle City" by | |||||||||
| __*Lifetime* $300.00 | Elva Scott (retail value $20.00). | |||||||||
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Check |
__Active Member (Voting) | |||||||||
| __Friend of the Society (Non-Voting) | ||||||||||
| Amt. of MEMBERSHIP Donation: | ||||||||||
| Additional GIFT Donation: | ||||||||||
| TOTAL ENCLOSED: | ||||||||||
Sincere thanks for your continuing support!
| COMPLETE THIS TO PAY WITH CREDIT CARD ** Mastercard - Visa - Discover only ** | |
| Card No.: | PRINT Name on Card: |
| Exp. Date: | Cardholder Signature: |
| Date Signed: | |
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Eagle Historical Society & Museums,
PO Box 23, Eagle Alaska 99738 - USA |